What would Tennessee Medicaid look like under block grant funding?

Tennessee lawmakers approved in May a bill requiring the state to submit a plan to President Donald Trump's administration to fund its Medicaid program through a block grant. As the state prepares this plan, The Tennessean took a look into what a block grant is and how it could transform Medicaid.

States historically have not had big restrictions on the amount of federal Medicaid money they receive. But the federal government announced in January that it was working on a plan to allow states to receive fixed block grants for Medicaid spending in exchange for giving states more flexibility in implementing the program.

If the federal government approves Tennessee's plan, a block grant would provide it with federal Medicaid funding in a new way and essentially transform the state's Medicaid program, TennCare, according to The Tennessean.

TennCare, a Medicaid managed care program operated by the state, provides healthcare for about 1.3 million Tennesseans, primarily low-income pregnant women, children and elderly or disabled individuals.

The federal government establishes rules for coverage and in most years gives TennCare about $7.5 billion, The Tennessean reported, adding that funding is adjusted based on whether TennCare shrinks or grows.

A block grant system would give Tennessee greater authority in running TennCare, and the state would receive federal Medicaid funding as a lump sum or a set amount per program enrollee, according to the newspaper. That amount couldn't increase once the initial money is gone.

Under the block grant system, Tennessee officials would likely be able to control who is eligible for the program, as well as the medications and treatments covered under TennCare, according to The Tennessean.